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Panic Disorder

Everyone experiences feelings of anxiety and panic at certain times during their lifetime, as these feelings are a natural response to stressful or dangerous situations. Most people will experience a panic attack once or twice in their lives [1], it can happen at different times for everyone – they may be triggered by particular places, situations, or activities. For example, a panic attack might occur before a stressful appointment or event. However, for someone with panic disorder, feelings of anxiety, stress and panic occur regularly and can happen at any time. Panic disorder is characterised by recurring and regular panic attacks, that occur often and for no apparent reason [2].

Panic attacks are a type of fear response, they are an exaggeration of the body's normal response to danger, stress, or excitement. A panic attack occurs when an individual experiences a rush of intense psychological and physical symptoms, including an overwhelming sense of fear, apprehension, and anxiety. They typically last for 5 to 20 minutes. As well as these feelings, they may also have physical symptoms such as:

  • a racing heartbeat

  • dizziness or feeling faint

  • sweating, hot flushes, or chills

  • nausea or a churning stomach

  • chest pain or shortness of breath

  • a choking sensation

  • dry mouth

  • trembling or shaky limbs

  • numbness or pins and needles, a tingling in your fingers

  • a need to go to the toilet

  • ringing in your ears

  • a feeling of dread or a fear of dying

  • feeling like you're not connected to your body [3].

Panic disorder is defined by at least 1 month of persistent fear about panic attacks (or their effects) reoccurring [1]. Individuals with panic disorder may experience lots of panic attacks at unpredictable times, and there doesn't seem to be a particular trigger or cause.

The reason that panic disorder develops in some individuals is not yet fully understood but is thought to be linked to a combination of physical and psychological factors. One factor that may contribute to the development of panic disorder is traumatic life experiences, such as being involved in a life-threatening event, being abused or bullied, traumatic childbirth or bereavement, or experiencing or witnessing violence. In addition, significant life events or changes that cause a lot of stress may also contribute to the development of panic disorder, such as moving or leaving home, getting married, having a child, or starting a new job. Transitional stages can be very overwhelming and are often times of high stress, so it is important to take care of both mental and physical health during these periods [1]. Genetics may also be a factor in the development of panic disorder, as having a close family member with panic disorder is thought to increase a person’s risk of developing it [4]. Some individuals are more prone to feelings of anxiety, and may be more susceptible to becoming worried, nervous, or overwhelmed, which may intensify feelings of panic and lead to an increased occurrence of panic attacks. Individuals suffering with an anxiety disorder such as generalised anxiety disorder (GAD), obsessive compulsive disorder (OCD), or social anxiety disorder (SAD), are also more likely to experience panic attacks when their anxiety is triggered, however having a panic attack doesn’t necessarily indicate the presence of panic disorder [1].

Panic disorder can also lead individuals into a vicious cycle of panic, in which concerns about having a panic attack or the symptoms meaning they have a physical health problem perpetuate the feelings of panic. For example, an individual may start to notice symptoms of panic, such as their heart rate increasing. As this can sometimes be an indication of the beginning of a panic attack, experiencing increased heart rate may cause the individual to become worried about having a panic attack as well as the possible consequences, such as feeling embarrassed or judged by other people. Others might misinterpret this symptom as having a heart attack or that they might faint, which is known as catastrophising, which is where a person fixates on the worst possible outcome and treats it as likely, even when it is not [5]. Becoming preoccupied by the thought of the worst-case scenario occurring often creates and feeds into fear, causing actual symptoms of panic to arise or worsen. In this way, panic attacks may be triggered seemingly without reason, but are as a result of underlying fear or anticipation of a panic attack occurring.

Panic disorder can greatly interfere with everyday life, as it can be draining and debilitating to live in constant fear of a panic attack occurring. However, there are treatments available that focus on reducing or eliminating symptoms. One effective treatment for reducing symptoms of panic disorder is cognitive behavioural therapy (CBT). CBT focuses on developing an understanding about the relationship between thoughts, feelings, and behaviour, and how unhelpful patterns can maintain feelings of anxiety. CBT helps people to overcome negative thinking patterns by teaching them skills to recognise, challenge, and replace negative thoughts related to panic attacks. CBT can also help with learning new ways to manage and cope with panic and panic attacks, providing individuals with the tools to overcome their anxiety by practicing in therapy and managing independently outside of therapy in everyday life. Read more about CBT for anxiety here.

Another practice that can be helpful in reducing symptoms of panic disorder is mindfulness. Mindfulness is a tool we can use to deal with negative emotions such as panic and helps us to remain grounded in the present moment rather than becoming swept up in our negative thoughts. Mindfulness is a practical skill that can be learnt independently or in a guided practice, for example through yoga or meditation, or through a mindfulness-based therapy such as Mindfulness-Based Cognitive Therapy (MBCT), or Mindfulness-Based Stress Reduction (MBSR). Read more about mindfulness here.

At Surrey Therapy Practice, we have a team of experienced professionals who specialise in a range of therapies that can help to treat panic disorder in people of all ages. Many of our therapists use an integrative approach to tailor their treatment plans to specific individual needs. If think you or someone you know is suffering with panic disorder, get in touch and make an enquiry here.



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